Atle Ødegård

Perceptions of interprofessional collaboration in relation to children with mental health problems. A pilot study

The primary aim of this paper is to present some findings from a pilot study and to outline a tentative model of interprofessional collaboration. A second aim is to reflect on how to design a main study. Seven professionals from school psychology services (3), a childrens psychiatric clinic (2) and an elementary school (2), participated in the study. Two methods were used: Semi-structured interview in combination with a vignette and the Sentence Completion Technique. Categorization was used as the central analyzing tool together with condensation and interpretations. The data analysis is supported by the software program Nud*Ist N6. The results are presented in three main sections: (a) interprofessional group variations, (b) the situation of the central actors, and (c) collaboration as a working method.

Time used on interprofessional collaboration in child mental health care

This study investigates a sample of professionals (N = 134) who work with children with mental health problems, in the western part of Norway. A 48-item questionnaire was designed to measure different aspects of interprofessional collaboration. Two demographic questions in the questionnaire focused on how much time professionals use on interprofessional collaboration on a regular working-day and results from these two questions are reported. How much time do professionals use on interprofessional collaboration within the context of helping children with mental health problems? Do professionals collaborate more within their own organization than with professionals from external organizations? The results show that professionals, on average, use about 40% of their time on collaboration activities. Professionals, as expected, collaborate more with professionals from their own organization than with professionals from other health care services.

A conceptual framework for assessing interorganizational integration and interprofessional collaboration

The need for collaboration in health and social welfare is well documented internationally. It is related to the improvement of services for the users, particularly target groups with multiple problems. However, there is still insufficient knowledge of the complex area of collaboration, and the interprofessional literature highlights the need to develop adequate research approaches for exploring collaboration between organizations, professionals and service users. This paper proposes a conceptual framework based on interorganizational and interprofessional research, with focus on the concepts of integration and collaboration. Furthermore, the paper suggests how two measurement instruments can be combined and adapted to the welfare context in order to explore collaboration between organizations, professionals and service users, thereby contributing to knowledge development and policy improvement. Issues concerning reliability, validity and design alternatives, as well as the importance of management, clinical implications and service user involvement in future research, are discussed.

A mixed method approach to clarify the construct validity of interprofessional collaboration: An empirical research illustration

The rapid development of empirical studies in the field of interprofessional collaboration (IPC) calls for a wide array of scientific approaches ranging from recruitment and motivation to measurement and design questions. Regardless of whether researchers choose qualitative or quantitative approaches, they must substantiate their findings. We argue that more attention should be given to reliability and validity issues to improve our understanding of IPC as a phenomenon and practice. A mixed methods approach is presented as a relevant design format for the study of IPC. This paper aims to argue that a combination of methodologies may be a feasible way to enhance our understanding of IPC, with a special focus on reliability and validity issues; illustrate the application of different methodologies in an IPC research project; and emphasize the distinction between validity and validation to mitigate possible obstacles in integrating qualitative and quantitative research in the study of IPC.

Testing the Diagnosis of Dissociative Identity Disorder Through Measures of Dissociation, Absorption, Hypnotizability and PTSD: A Norwegian Pilot Study

A total of 14 women meeting criteria for dissociative identity disorder (DID) based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM–IV]) were compared to a group of women (n = 10) with other dissociative diagnoses and a group of normal controls (n = 14) with regard to dissociativity, absorption, trauma related symptoms and hypnotizability. Both of the clinical groups reported histories of childhood trauma and attained high PTSD scores. The DID group differed significantly from the group with other dissociative diagnoses and the non-diagnosed comparison group with regard to hypnotizability, the variety of dissociative symptomatology, and the magnitude of dissociative symptomatology. However, no significant differences between the two clinical groups were detected with regard to absorption, general dissociative level, or symptoms related to traumatic stress. Results support the notion that DID can be regarded as a clinical entity which is separable from other dissociative disorders. Results also indicated that hypnotizability is the most important clinical feature of DID.

Cognitive Complexity and Dissociative Identity Disorder

Thirteen patients with dissociative identity disorder (DID), 13 with other mental disorders, and 10 nondiagnosed comparison participants were given individual grids. Results showed that displaying alternate personalities did not portend a more multidimensional level of thinking. Instead, the nonclinical comparison group had the greater degree of complexity in comparison to both clinical groups. A notable clinical observation was that DID patients, as compared to non-DID participants, had a greater understanding and speed in completing the grid. Findings are discussed in terms of the advantages of personal construct theory for conceptualizing the construct of dissociation.

Collaborative practices between correctional and mental health services in Norway: Expanding the roles and responsibility competence domain

ABSTRACT Internationally, mental illness is high in prison populations. Collaboration between the correctional services (CS) and mental health services (MHS) is required to address this. Little is known of the collaborative processes in this context, however. This article presents the findings of a study exploring the characteristics of collaborative practices between the MHS and CS in a Norwegian context. A purposeful sample (n = 12) of MHS and CS leaders was recruited from one region in Norway. Taking a generic qualitative approach, semi-structured interviews with each participant explored specific structures that promoted collaboration, the nature of collaborative relationships, and factors that facilitated or constrained these. The study indicated that leaders are exercised by one dimension of collaborative practice in particular, namely the distribution of responsibility for the care of the offender across systems. This activity is mediated by highly complex external structures as well as the individual characteristics of the professionals involved. They speculate that professionals and organisations who fail to take responsibility for the offender as expected may be constrained from doing so by resource limitations, logistical issues, and poor attitudes towards the offender population. Based on these findings, this study suggests that the MHS and CS workforce would benefit from a great knowledgeability of the roles and responsibility domains of collaborative practice. Improving competence in the workforce in this area would achieve this. However, competency frameworks that address this domain are currently limited. Recommendations on how to extend the remit of this domain in light of the current findings are provided.

Using Social Innovation as a Theoretical Framework to Guide Future Thinking on Facilitating Collaboration Between Mental Health and Criminal Justice Services

Offender mental health is a major societal challenge. Improved collaboration between mental health and criminal justice services is required to address this challenge. This article explores social innovation as a conceptual framework with which to view these collaborations and develop theoretically informed strategies to optimize interorganizational working. Two key innovation frameworks are applied to the offender mental health field and practice illustrations provided of where new innovations in collaboration, and specifically co-creation between the mental health system and criminal justice system, take place. The article recommends the development of a competency framework for leaders and front line staff in the mental health system and criminal justice systems to raise awareness and skills in the innovation process, especially through co-creation across organizational boundaries.

University teachers’ views of interprofessional learning and their role in achieving outcomes - a qualitative study

ABSTRACT Over the past decade, there has been a rapid increase in higher education institutions offering opportunities for interprofessional learning (IPL) to their students. The literature presents a number of factors that contribute to effective IPL, including having trained facilitators that help optimise the learning process. Many of these IPL facilitators are university teachers and the literature provides us with some insight into their views of IPL. However, little is known about university teachers’ views about IPL and their role in supporting students in achieving outcomes linked to IPL during their own teaching; this paper explores these areas. University teachers, working with students in Norway and England who contribute to patients’ care pathway were purposively invited to join focus groups. Data collected from the teachers’ conversations during these focus groups were analysed to elicit the main themes. Findings show that university teachers have a wide range of views about IPL, its potential to enhance collaborative practice and care, and their role in helping students achieve outcomes linked to IPL. A key challenge appears to be whether IPL is “worth the struggle,” which emphasises the need for strong leadership in order to align pedagogical approaches in education and practice that strive to achieve agreed outcomes.

Lederen som innovatør og balansekunstner : en kvalitativ studie av lederes erfaringer fra forskningssamarbeid mellom helse- og velferdstjenestene og høyere utdanning

The manager as innovator and equilibrist: a qualitative study of the experiences of Norwegian managers in health and welfare service taking part in research partnership with higher education Managers in health and welfare services have overall responsibility to develop the services according to official regulations and the needs of society. They are expected to provide high quality, research based services. Higher education is expected to transform education and research that improve the services, and to develop research collaborating with the practical field. This study investigates experiences of managers in health and welfare services taking part in research collaboration with higher education. Data were collected through focus group interviews with altogether 14 participants involved in 21 projects, and analysed by using qualitative content analyses. The experiences of the managers can be summarised as “Being an innovator and equilibrist in order to develop the service”. Managers appear to play an important role in bridging between health and welfare services and higher education. In order to enhance research partnerships between health and welfare services and higher education formal collaborative structures should be established.